Patient Clinical Data Integration in Integrated Electronic Medical Record System for Health Care Facilities in Indonesia
Abstract: Complete patient
service requires continuous support of clinical history. This can be realized
by integrating electronic medical record data. The limitation is the wide
variety of software, formats, and data dictionaries used in healthcare
facilities. This was a descriptive analysis study with cross sectional approach
to find open source electronic medical record integration model for clinical
data exchange between health care facilities. Respondents were doctors, nurses,
pharmacists, laboratory staffs, and person in charge of hospital information
system as informant for content analysis. From the study, we managed a
web-based service portal to implement clinical data integration that can be
accessed by clinician registered within the Ministry of Health. The patients
clinical history is stored in the hospital database and requires unique
OpenIDRM code on the Health Service Server to integrate it. OpenIDRM contains
all of the patients medical record number, as one patient may have several
different medical record numbers in several hospitals. In conclusion, clinician
can access the patients clinical history by opening a web portal system through
a unique OpenIDRM code.
Keywords: rekam medis
elektronik, electronic health record, medical record, opensource, interoperability
Author: Arif Kurniadi, Retno
Pratiwi
Journal Code: jpkesmasgg170093
